The impact of video gaming on cognitive functioning of people with schizophrenia (GAME-S): study protocol of a randomised controlled trial

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Abstract

Background

Video gaming is a promising intervention for cognitive and social impairment in patients with schizophrenia. A number of gaming interventions have been evaluated in small-scale studies with various patient groups, but studies on patients with schizophrenia remain scarce and rarely include the evaluation of both clinical and neurocognitive outcomes. In this study, we will test the effectiveness of two interventions with gaming elements to improve cognitive and clinical outcomes among persons with schizophrenia.

Methods

The participants will be recruited from different outpatient units (e.g., outpatient psychiatric units, day hospitals, residential care homes). The controlled clinical trial will follow a three-arm parallel-group design: 1) cognitive training (experimental group, CogniFit), 2) entertainment gaming (active control group, SIMS 4), and 3) treatment as usual. The primary outcomes are working memory function at 3-month and 6-month follow-ups. The secondary outcomes are patients’ other cognitive and social functioning, the ability to experience pleasure, self-efficacy, and negative symptoms at 3-month and 6-month follow-ups. We will also test the effectiveness of gaming interventions on neurocognitive outcomes (EEG and 3 T MRI plus rs-fMRI) at a 3-month follow-up as an additional secondary outcome. Data will be collected in outpatient psychiatric services in Hong Kong. Participants will have a formal diagnosis of schizophrenia and be between 18 and 60 years old. We aim to have a total of 234 participants, randomly allocated to the three arms. A sub-sample of patients ( N = 150) will be recruited to undergo an EEG. For neuroimaging assessment, patients will be randomly allocated to a subset of patients ( N=126). We will estimate the efficacy of the interventions on the primary and secondary outcomes based on the intention-to-treat principle. Behavioural and EEG data will be analysed separately.

Discussion

The study will characterise benefits of gaming on patients’ health and well-being, and contribute towards the development of new treatment approaches for patients with schizophrenia.

Trial registration

ClinicalTrials.gov NCT03133143. Registered on April 28, 2017.

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Most cited references 51

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Neurocognitive Deficits and Functional Outcome in Schizophrenia: Are We Measuring the "Right Stuff"?

J. Mintz, M. Green, D Braff … (2000)

There has been a surge of interest in the functional consequences of neurocognitive deficits in schizophrenia. The published literature in this area has doubled in the last few years. In this paper, we will attempt to confirm the conclusions from a previous review that certain neurocognitive domains (secondary verbal memory, immediate memory, executive functioning as measured by card sorting, and vigilance) are associated with functional outcome. In addition to surveying the number of replicated findings and tallying box scores of results, we will approach the review of the studies in a more thorough and empirical manner by applying a meta-analysis. Lastly, we will discuss what we see as a key limitation of this literature, specifically, the relatively narrow selection of predictor measures. This limitation has constrained identification of mediating variables that may explain the mechanisms for these relationships.

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A meta-analysis of cognitive remediation in schizophrenia.

Susan R. McGurk, Elizabeth Twamley, David I Sitzer … (2007)

This study evaluated the effects of cognitive remediation for improving cognitive performance, symptoms, and psychosocial functioning in schizophrenia. A meta-analysis was conducted of 26 randomized, controlled trials of cognitive remediation in schizophrenia including 1,151 patients. Cognitive remediation was associated with significant improvements across all three outcomes, with a medium effect size for cognitive performance (0.41), a slightly lower effect size for psychosocial functioning (0.36), and a small effect size for symptoms (0.28). The effects of cognitive remediation on psychosocial functioning were significantly stronger in studies that provided adjunctive psychiatric rehabilitation than in those that provided cognitive remediation alone. Cognitive remediation produces moderate improvements in cognitive performance and, when combined with psychiatric rehabilitation, also improves functional outcomes.

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The benefits of playing video games.

Isabela Granic, Adam Lobel, Rutger C. M. E. Engels (2013)

Video games are a ubiquitous part of almost all children's and adolescents' lives, with 97% playing for at least one hour per day in the United States. The vast majority of research by psychologists on the effects of "gaming" has been on its negative impact: the potential harm related to violence, addiction, and depression. We recognize the value of that research; however, we argue that a more balanced perspective is needed, one that considers not only the possible negative effects but also the benefits of playing these games. Considering these potential benefits is important, in part, because the nature of these games has changed dramatically in the last decade, becoming increasingly complex, diverse, realistic, and social in nature. A small but significant body of research has begun to emerge, mostly in the last five years, documenting these benefits. In this article, we summarize the research on the positive effects of playing video games, focusing on four main domains: cognitive, motivational, emotional, and social. By integrating insights from developmental, positive, and social psychology, as well as media psychology, we propose some candidate mechanisms by which playing video games may foster real-world psychosocial benefits. Our aim is to provide strong enough evidence and a theoretical rationale to inspire new programs of research on the largely unexplored mental health benefits of gaming. Finally, we end with a call to intervention researchers and practitioners to test the positive uses of video games, and we suggest several promising directions for doing so. PsycINFO Database Record (c) 2014 APA, all rights reserved.

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Author and article information

Contributors

Maritta Välimäki:

ORCID: http://orcid.org/0000-0003-3124-9290

maritta.vaelimaeki@csu.edu.cn

Journal

Journal ID (nlm-ta): BMC Psychiatry

Journal ID (iso-abbrev): BMC Psychiatry

Title: BMC Psychiatry

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-244X

Publication date (Electronic): 18 January 2021

Publication date PMC-release: 18 January 2021

Publication date Collection: 2021

Volume: 21

Electronic Location Identifier: 46

Affiliations

[1 ]GRID grid.216417.7, ISNI 0000 0001 0379 7164, Xiangya Nursing School, , Central South University, ; 172 Tongzipo Road, Changsha, 410013 Hunan China

[2 ]GRID grid.16890.36, ISNI 0000 0004 1764 6123, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, ; Hong Kong, Hong Kong SAR

[3 ]GRID grid.1374.1, ISNI 0000 0001 2097 1371, Department of Nursing Science, Faculty of Medicine, , University of Turku, ; 20014 Turku, Finland

[4 ]GRID grid.13291.38, ISNI 0000 0001 0807 1581, West China School of Public Health, , Sichuan University, ; Chengdu, China

[5 ]GRID grid.1027.4, ISNI 0000 0004 0409 2862, Faculty of Health, Art and Design, , Swinburne University of Technology, ; Melbourne, Victoria 3122 Australia

[6 ]GRID grid.7737.4, ISNI 0000 0004 0410 2071, Neuroscience Center, , University of Helsinki, ; Helsinki, Finland

[7 ]GRID grid.16890.36, ISNI 0000 0004 1764 6123, Department of Rehabilitation Sciences, Hung Hom, Kowloon, , The Hong Kong Polytechnic University, ; Hong Kong, Hong Kong SAR

[8 ]GRID grid.415504.1, ISNI 0000 0004 1794 2766, Department of Psychiatry, , Kowloon Hospital, ; Hong Kong, Hong Kong SAR

[9 ]The Mental Health Association of Hong Kong, 2 Kung Lok Road, Hong Kong, Hong Kong SAR

[10 ]GRID grid.194645.b, ISNI 0000000121742757, Department of Diagnostic Radiology, The Hong Kong Jockey Club for Interdisciplinary Research, , The University of Hong Kong, ; 5 Sassoon Road, Hong Kong, Hong Kong SAR

[11 ]GRID grid.417134.4, ISNI 0000 0004 1771 4093, Department of Psychiatry, Community Psychiatry, , Pamela Youde Nethersole Eastern Hospital, ; Hong Kong, Hong Kong SAR

[12 ]GRID grid.1043.6, ISNI 0000 0001 2157 559X, College of Nursing and Midwifery, , Charles Darwin University, ; Darwin, Australia

Author information

Maritta Välimäki http://orcid.org/0000-0003-3124-9290

Article

Publisher ID: 3031

DOI: 10.1186/s12888-020-03031-y

PMC ID: 7814579

SO-VID: f9a8b26f-dc28-4df7-93c3-825fcffad412

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 25 November 2020

Date accepted : 22 December 2020

Funding

Funded by: Research Grant Council in Hong Kong

Award ID: 15600418

Award Recipient : Maritta Välimäki

Funded by: FundRef http://dx.doi.org/10.13039/501100004377, Hong Kong Polytechnic University;

Award ID: YBYB, ID P0009721

Award Recipient : Maritta Välimäki

Funded by: University of Turku

Award ID: 26003424

Award Recipient : Maritta Välimäki

Custom metadata

ScienceOpen disciplines: Clinical Psychology & Psychiatry

Keywords: gaming,randomised controlled trial,schizophrenia,effectiveness

Data availability:

ScienceOpen disciplines: Clinical Psychology & Psychiatry

Keywords: gaming, randomised controlled trial, schizophrenia, effectiveness

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The impact of video gaming on cognitive functioning of people with schizophrenia (GAME-S): study protocol of a randomised controlled trial

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Abstract

Background

Methods

Discussion

Trial registration

Related collections

Journal of Behavioral Addictions

Most cited references 51

Neurocognitive Deficits and Functional Outcome in Schizophrenia: Are We Measuring the "Right Stuff"?

A meta-analysis of cognitive remediation in schizophrenia.

The benefits of playing video games.

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